Provider Demographics
NPI:1679396394
Name:WATERS, MERRIAH L (LPCA)
Entity type:Individual
Prefix:MRS
First Name:MERRIAH
Middle Name:L
Last Name:WATERS
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 MILL PLAIN RD STE C
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-6101
Mailing Address - Country:US
Mailing Address - Phone:203-240-7093
Mailing Address - Fax:
Practice Address - Street 1:98 MILL PLAIN RD STE 3C
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-6101
Practice Address - Country:US
Practice Address - Phone:203-240-7093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6892101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor